Sexual diseases and their symptoms. Practical manual for patient

Sexually transmitted diseases are infectious, that is, arising due to the introduction of various pathogens. They are broadcast from person to person only contact and mainly during sex.

The generally accepted definition does not raise questions among doctors, but for patients it is better to decipher it point by point:

• Pathogens can be bacteria, protozoa, fungi, rickettsiae or viruses. Mixed infection is possible - infection by several types of microorganisms at once.
• A sexually transmitted disease is a local and general manifestation of the impact of infection on a person.
• For infection, you need a source of infection (the patient or a carrier) and the route through which the pathogens are transmitted. Infection with a sexually transmitted disease is possible if there is:
  1. Sexual transmission during any sexual activity (traditional, oral or anal intercourse). Pathogens are transmitted from the skin or mucous membranes of the genitals, anus (anus), lips and oral cavity.
  2. Transmission - infection through blood - through transfusion of whole blood, red blood cells; infection from needles or instruments on which the blood of a patient or a carrier of infection remains.
  3. Contact and household route: through linen or objects that are contaminated with infectious secretions.

The word “venereal” is associated with the name of Venus, the Roman goddess of love: it emphasizes that diseases are more often transmitted through sexual contact.

What diseases are considered sexually transmitted, their classification

Modern sources provide a list of sexually transmitted infections. The list includes only two dozen diseases. Among them are 5 original venereal diseases:

And a number of STDs, which today are conventionally called “venereal”, based on the sexual route of infection:

• , And , , .
• Some sources also classify intestinal giardiasis and amebiasis as STDs, although sexual transmission (mainly anal) is not the main route for them.

Sexually transmitted diseases are classified in very different ways:

According to etiological principle(based on the reasons for the development of diseases), ailments are divided into viral, bacterial, fungal, etc.

According to the effect on the body There are genital types of sexually transmitted diseases (for example, gonorrhea, vaginal trichomoniasis), skin types (pediculosis pubis, scabies, condylomas) and those affecting other organs and systems of the human body (viral hepatitis B and C, amoebiasis, AIDS, giardiasis).

In accordance with the age of the description of the signs distinguish between classic, known even before our era, venereal diseases - syphilis, gonorrhea, donovanosis, chancroid and lymphogranuloma venereum (all of them are oral infections), and the so-called new venereal diseases - the rest of the list.

The names of some classic STDs have historical roots: the godfather of gonorrhea was an ancient Roman doctor Galen, who observed the "flow of seed" and used Greek words to describe this feature. The word “syphilis” is associated with a myth according to which the gods, offended by disrespect, punished a shepherd named Syphilus with a genital disease. There was even a poem dedicated to this plot, where the main symptoms were described in detail. A later name is lues ( lues) – translated from Latin means “contagious disease”, and it appeared after the syphilis epidemic in Europe, which lasted about 50 years (late 15th – mid 16th centuries). The names of new STDs are derived from the names of pathogens (trichomoniasis, chlamydia, etc.) and virus serovars (viral hepatitis B and C), main manifestations (scabies, condylomas) or symptom complexes (AIDS).

Prevalence and risk groups

Top lines of the world rankings, including the most common sexually transmitted diseases , Trichomoniasis and chlamydia are firmly occupied: up to 250 million cases are identified annually, and the proportion of those infected is about 15% of the total population of the Earth. They are followed by gonorrhea (100 million “fresh” cases of the disease per year) and syphilis (up to 50 million). The graphical representation of morbidity resembles a wave, the peaks of which occur during times of social change for the worse and the post-war years.

Reasons causing an increase in the incidence of STDs:

1. Demographic – population growth, an increase in the proportion of young and sexually active people, traditions of early sexual activity.
2. Progress in the socio-economic sphere - labor migration, tourism development, more free time and money, youth attraction to cities and availability of sexual contacts.
3. Behavioral norms are changing: more divorces, easy change of sexual partners; women are emancipated, and men are in no hurry to start a family.
4. Medical reasons - frequent cases of self-medication and the transition of diseases into a latent form; women and men feel safe using condoms and instant STD prevention.
5. Prevalence of drug addiction and alcoholism.

Traditional risk groups include prostitutes, homeless people, illegal migrants, alcoholics and drug addicts leading a “non-prestigious” lifestyle. However, they are confidently being overtaken by the growing incidence rate among quite successful people: personnel of companies operating abroad; those employed in the tourism business and tourists; sailors, pilots and flight attendants are also included in the list of unreliable STDs.

Incubation period

The appearance of visible changes at the site of infection is the result of the reproduction and vital activity of STD pathogens. A small number of infectious agents can be rebuffed by the immune system and die, and for the development of signs of the disease, the law of the transition of quantity into quality needs to work. Therefore, any infectious diseases have an incubation period - a period of time necessary for the number of pathogens to increase and the first visible symptoms of infection to appear (for STDs - rash, discharge).

Typically, the incubation period figures are given in days, for viral infections - in hours. Incubation time may vary, which is associated with the duration of contact, the amount of a single dose of pathogens, the route of transmission and the state of the immune system of the recipient person. The incubation period (IP) is shortened in elderly and weakened patients, with transmission of pathogens and in patients with immunodeficiency syndrome.

IP for some common sexually transmitted infections (per day):

• Chlamydia: 7-21 days;
• Trichomoniasis: 7-28 days;
• Gonorrhea: 2-10 days;
• Urea and mycoplasmosis: 21-35 days;
• Syphilis: 21-28 days;
• Genital herpes: from 1 to 26, usually 2-10 days;
• (pointed): 30-90 days.

The main manifestations of classical venereal diseases

Symptoms of sexually transmitted diseases are divided into primary signs that appear on the skin or mucous membranes at the site of entry of pathogens, and general associated with their toxic effects on the body. For example, - these are local manifestations of sexually transmitted infections, and fever is a general symptom.

Syphilis

The causative agent of syphilis ( Treponevapallidum, spiral-shaped bacterium or spirochete) is predominantly transmitted through sexual contact. The risk of becoming infected during unprotected sex reaches 30%. In the external environment, spirochetes are unstable; to maintain activity they require certain temperatures and humidity. The mucous membrane of the genital organs, mouth or rectum serves as such an “incubator”. The infection can also be transmitted in utero - to the child from the mother, or through a transfusion of contaminated blood.

Primary a sign of syphilis infection: it appears at the site of direct introduction of treponemes and at first does not cause concern. A compaction appears, then in its place a round ulcer with a hard bottom and raised edges appears. There is no pain, but the chancre can be small in size - from 1 cm in diameter. After a couple of weeks, the lymph nodes, which are located closer to the chancre, enlarge, but they are also painless and do not bother the patient. The chancre heals on its own in 1-1.5 months. after appearance, however, the infection remains in the body and syphilis goes into the secondary period.

Start secondary syphilis is a symmetrical venereal rash ( roseola), which often appears even on the feet and palms. When the rash occurs, the temperature rises and the lymph nodes enlarge throughout the body. Characteristic is the alternation of deterioration and improvement of the general condition - periods of exacerbations and remissions. Among skin manifestations, warts (condylomas lata), which are localized in the perineum and anus, can attract the patient’s attention; Hair loss on the scalp is also noticeable.

syphilitic roseola

Tertiary the period of syphilis is associated with severe internal diseases that develop within several years after infection. If left untreated, about 1/4 of patients die.

Gonorrhea

The causative agent is paired cocci, which under a microscope look like coffee beans, with their concave side facing each other. The name is sonorous - Neisseriagonorrhoeae, given to microbes in honor of their discoverer, venereologist A.L. Neisser. Gonococci are introduced exclusively through the mucous membranes, more often - the genitals, rectum and orally, less often - the eyes (gonoblepharrea of ​​newborns when a child is infected from the mother). The household route of transmission of infection is impossible, because gonococci are very sensitive to temperature and humidity conditions.

in the photo: gonorrheal discharge in men and women

Basicsigns infections - purulent inflammation of the mucous membranes. When transmitted sexually, both partners almost always develop (inflammation of the urethra). Gonorrhea is distinguished by (urination), ; even at rest they can. The discharge during the acute period is profuse and purulent, the color ranges from white to yellow. When transitioning to the chronic form, there is little discharge, they become whitish and thick.

Important: in contrast, with gonorrhea they are often minor, they can be mistaken for a symptom of nonspecific urethritis, cystitis or. Be sure to make an appointment with a doctor if the discharge occurs for more than one cycle and has a putrid odor; if there is bleeding between menstruation; if you “don’t have the strength” and your lower back is constantly aching.

Complications are associated with ascending urogenital infection. In women, gonococci affect the uterus, tubes and ovaries, in men - the testicles, epididymis (), and prostate. The standard result of chronic gonorrhea is adhesions internal organs. If adequate treatment is not received or the immune system has failed, gonococcal infection is possible. sepsis(blood poisoning) with a fatal outcome or the infection spreading to internal organs (liver, heart, brain) and an unclear prognosis for later life. The sad, although not fatal, result of chronic gonorrhea is 100% male and female infertility.

Soft chancre (shacroid)

The causative agent is a bacillus Haemophilusducreyi. The disease is mainly “associated” with countries where there is a warm and humid climate (Africa, Asia, South America); it is rare in European countries. Infection occurs through sexual contact, through anal and oral sex. The chances of getting an infection during one time of unprotected sex are 50 to 50.

differences between soft chancre and hard chancre (syphilitic)

Signsinfection: the primary manifestation is a red spot, indicating the locus of infection. Then a purulent blister appears and turns into an irregularly shaped ulcer, soft and painful. The diameter of the ulcer varies from 3-5 mm to 3-10 cm or more. Then the lymph vessels become inflamed ( lymphangitis), forming painful subcutaneous cords. In men they are palpated on the back of the penis, in women - on the skin of the labia majora and on the pubis. After 7-21 days, inflammation spreads to the lymph nodes ( lymphadenitis); dense buboes appear, which later turn into soft ulcers and open. Complications- swelling of the foreskin, pinching of the glans penis, gangrene of the genitals.

With chancre, skin manifestations are numerous and are at different stages of development: spots, ulcers and scars are visible at the same time.

Lymphogranuloma venereum (inguinal lymphogranulomatosis)

The causative agent of lymphogranuloma venereum - some serotypes Chlamydiatrachomatis. The disease is quite rare in Europe; mainly “imported” infections and cases associated with port cities are recorded. The possibility of becoming infected through everyday life exists, but transmission of the infection mainly occurs through sexual contact.

in the photo: signs of lymphogranulomatosis venereum - inflamed inguinal lymph nodes in women and men

Basicmanifestations: 1-3 weeks after infection, a vesicle appears at the site of chlamydia penetration, which disappears without treatment and may go unnoticed. Then the regional lymph nodes enlarge, merging with each other; the skin over the source of inflammation is purple-violet, palpation causes pain. Next, suppuration occurs, the formations are opened with the flow of yellowish pus.

Complications inguinal lymphogranulomatosis – fistulas anal, scrotum, urethra, recto-vaginal, between the rectum and bladder. Later development is possible elephantiasis genitals due to local lymphostasis, strictures(narrowing) of the rectum and urethra.

in the photo: manifestations of donovanosis on the genitals

Donovanosis (venereal (inguinal) granuloma)

Donovanosis is an exotic disease native to the tropics. The causative agents are callimatobacteria or corpusclesDonovan, they become infected through sexual and household contact. Symptoms develop slowly. It begins with the formation of a red nodule on the skin or mucous membrane of the genitals, mouth, or anus. Then the nodule turns into an ulcer with a velvety bottom and raised edges, the size of the defect increases over time. Strictures urethra, vagina and anus, elephantiasis– main complications of donovanosis.

Signs of infection with new STDs

photo: typical discharge from chlamydia

Chlamydia

Primary signs of infection atmen– urethritis with characteristic morning discharge in the form of a transparent drop. Uwomen– urethritis, inflammation of the cervix with scanty and cloudy secretions, associated pain and acyclic bleeding. Transmission of the infection is possible only through sexual contact; oral transmission is unlikely. Impossible become infected through contact and household contact (through pool water, toilet seats, bathhouses or bed linen.). Newborns can get chlamydial conjunctivitis or pneumonia from their mother during childbirth.

Trichomoniasis

The infection is transmitted sexually or by everyday means(the only one of the sexually transmitted diseases! although such cases are extremely rare), oral and anal infections are uncommon. In men, symptoms of urethritis and colpitis prevail, in women – colpitis. Trichomoniasis is characterized by yellowish, profuse, foamy discharge with an unpleasant odor, itching in the perineal area, pain during sexual intercourse and when urinating.

Mycoplasmosis

"sexual" types of mycoplasmas

Mycoplasmas occupy an intermediate position between bacteria and viruses and can live in the body of humans, animals and even plants. Capable of multiplying on the mucous membranes of the mouth and pharynx, and organs of the genitourinary tract. Often detected in healthy people, up to 50% of women are carriers of mycoplasmas. Mycoplasmahominis And M. genitalium are the cause of the development of urethritis in men, and bacterial vaginosis in women ( gardnerellosis), inflammation of the fallopian tubes and ovaries. Mycoplasma pyelonephritis may also develop. Infection occurs through sexual contact; transmission of the infection is unlikely through household contact.

Ureaplasmosis

Pathogens - Ureaplasmaparvum And U. urealyticum, causing urethritis in men and inflammation of the uterus and ovaries in women. Urolithiasis develops as a complication; spontaneous abortion or early birth is possible during pregnancy. Many completely healthy people become carriers of the infection; more often these are women.

Genital herpes

The causative agent is the herpes simplex virus ( Herpessimplex); Sexual transmission occurs through oral, anal and genital contact. Household spread of this virus is unlikely. The first sign of the disease is a painful spotty-bubble rash at the site of virus introduction; the patient feels sharp pain and burning, local swelling increases. At the same time, the general condition worsens, the temperature rises and a headache begins. The bubbles transform into erosions, from which a yellowish liquid is released. After 5-7 days, the erosions heal, leaving pigmentation. Relapse of the disease or reinfection is always possible.

HPV (human papillomavirus)

HPV causes a spectrum of different skin lesions, including pointedcondylomas. The cause is sexually transmitted infection, including oral infection, with HPV serotypes 6 and 11. Epithelial outgrowths resembling cockscombs form on the genitals. Formations can merge and increase in size. In women, genital warts are most often found in the vulva and vagina, in men - on the penis and inner leaf. preputium(foreskin). Warty growths are possible in the corners of the lips and on the tongue.

skin manifestations of papillomavirus infection - papillomas

Candidiasis (thrush)

Candidiasis is the result of rapid proliferation of fungi (genus Candida), which are normally always present in healthy people on the mucous membranes of the mouth, urogenital and intestinal tracts. It is classified as a sexually transmitted disease due to the possible sexual transmission and skin manifestations that are often observed in the genital area. Candidiasis can develop after treatment with antibiotics and corticosteroids (prednisolone, dexamethasone), with diabetes, AIDS, after prolonged stress, in the third trimester of pregnancy. Symptomsgenital candidiasis in women - curdled, sour-smelling vaginal discharge, pain when urinating and during sexual intercourse. In men, a whitish coating is visible on the head of the penis, pain is present during miction and after sexual intercourse.

Laboratory diagnostics

Laboratory examination using various techniques is the basis for diagnosing sexually transmitted diseases. Previously, preference was given visualidentification of pathogens, performing (cervix, vagina, urethra, rectum, pharynx) followed by microscopy. The technique is quite accurate, but the result takes at least a week, and the loss of time is a serious problem for the attending physician and the patient.

It is done quickly, the method is inexpensive and simple. The discharge is taken with a sterile swab: in men - from the urethra, in women - from three standard points (urethra, vestibule of the vagina, cervix). The material is then applied to a glass slide, stained, and examined under a microscope. You can determine the degree of inflammation by the number of leukocytes and evaluate the qualitative composition of the microflora. Viruses cannot be seen with light microscopy.

Modern diagnostic options in venereology - PIF analyzes ( directimmunofluorescence), (immunoenzyme). The material is secretions; the doctor receives the examination results within a few hours. The methods are cheap and widely available, but the accuracy is disappointing - only up to 70%. Therefore, these tests are used for preliminary diagnosis.

The final diagnosis is made based on the results, which means “ polymerasechain reaction"or a DNA test for the pathogen. The material is excretions and urine, the time to obtain the analysis result is up to 2 days, the accuracy is up to 95%. Preferably PCR is used to determine. In case of acute purulent inflammation, it is recommended to do PIF, ELISA, and culture.

(material – venous blood) indicates that there is an immune response to the presence of this pathogen, i.e. infection is determined by indirect signs and is not detected directly. Mainly used to determine viral diseases (genital herpes, HIV, viral hepatitis, cytomegalovirus) and syphilis. Antibodiesto bacteria remain in the blood for a long time; they are present even after complete recovery, which is why this method is never used to test for bacterial venereal diseases, chlamydia and ureaplasmosis.

Treatment

Treatment for bacterial STDs is carried out antibiotics, additionally including local procedures (urethral instillations), immunotherapy and physiotherapy. For combined infections (gonorrhea and chlamydia, syphilis and gonorrhea), drugs are used that act simultaneously on several pathogens. Viral infections (HIV, hepatitis B or C virus, herpes simplex virus) are treated with special agents, and antibiotics are prescribed only for accompanying complications caused by bacteria. It should be remembered that antibiotics do not work on viruses!

• Treatment acuteuncomplicated gonorrhea: tablets cefixime, ofloxacin (0.4 g once) or ciprofloxacin (0.5 g once).
• Chlamydia: doxycycline tablets 0.1 g x 1, or azithromycin 0.1 x 2, course 1 week.
• Soft chancre: once - azithromycin tablet. 1.0 g, or ciprofloxacin tab. 0.5 g x 2 courses for 3 days, or erythromycin tab. 0.5 g x 4 - course 1 week.
• Venereallymphogranulomatosis: tab. doxycycline (0.1 g x 2, course 3 weeks) or erythromycin (tablet 0.5 g x 4, course 1 week).
• Donovanosis: trimethoprim (0.16 g x 2) or doxycycline (0.1 g x 2), course up to 3 months.
• Ureaplasmosis: azithromycin tab. 1.0 g once, or doxycycline (tablet 0.1 g x 2, course 1 week).
• Candidiasis: for skin lesions - clotrimazole cream, twice a day, course 5-7 days. Orally – fluconazole tablets, 50-100 mg per day, course 5-7 days. For women - vaginal suppositories (clotrimazole, isoconazole). Suppositories betadine, polzhinax, terzhinan are considered ineffective against candidiasis, and can also cause vaginal dysbiosis and, as a result, the development of gardnerellosis.
• Herpetic rashes in the genital area: antiviral agents (acyclovir, Valtrex, farmciclovir). Oral and intravenous administration of the solution is more effective than local use in the form of ointments or creams. It is impossible to completely get rid of the herpes simplex virus; symptoms reappear when there are problems with the immune system (stress, acute respiratory infections and acute respiratory viral infections, AIDS).
• Condylomas acuminata removed (laser, cryotherapy, electrocoagulation), interferon injections are prescribed at the base of each wart. Antivirus pharma. the remedies are ineffective. Approximately a third of patients recover without treatment within 1-3 months; 25% experience a relapse after therapy or removal of genital warts.

Prevention of STDs

Spermicidal drugs (contraceptin, pharmatex) have not undergone clinical trials regarding protection against STDs, therefore their use as a means of prevention is not recommended.

The only and guaranteed way not to get sexually transmitted infections is a traditional monogamous relationship, a happy life with one partner.

Video: sexually transmitted diseases – “Health Expert”

Our expert - gynecologist Marina Vedeleeva.

Dangerous Thirty

The topic is very prosaic - sexually transmitted diseases (STDs). Almost every one of us has met them in person at least once in our lives. By the way, there are more than 30 of them: from the deadly HIV infection to the banal chlamydia, which, by the way, also cannot be called trivial. Moreover, in terms of prevalence in Russia, it is in second place after the flu.

Of course, most STDs are curable, but not all. For example, you will never be able to get rid of genital herpes - treatment only softens the course of the disease and reduces the frequency and severity of relapses. Only those under 25 have a chance to get rid of (HPV) forever. Later, it will not be possible to destroy the virus; the point of treatment is to eliminate changes in the tissues affected by the virus. By the way, it is believed that the human papillomavirus can cause cancer of the cervix, vagina, vulva and penis. The genital herpes virus also affects sperm, and if a woman is infected with it during pregnancy, it can cause severe congenital diseases of the fetus.

Treatment will be successful only if it is started without delay and completed. How to spot the very first danger signals?

The alarm has been declared!

There are seven main signs that you should not delay visiting a doctor if you discover them.

Itching and burning in the intimate area.

Redness in the genital area and anus, sometimes - ulcers, blisters, pimples.

Discharge from the genitals, odor.

Frequent, painful urination.

Enlarged lymph nodes, especially in the groin area.

In women - pain in the lower abdomen, in the vagina.

Discomfort during sexual intercourse.

However, for example, syphilis or chlamydia can appear several weeks after infection, and sometimes STDs can generally run latent for a long time, becoming chronic.

Let's get to know each other better

Chlamydia

Symptoms. 1–4 weeks after infection with it, patients develop purulent discharge, painful urination, as well as pain in the lower abdomen, lower back, bleeding between menstruation in women, and pain in the scrotum and perineum in men.

Why is it dangerous? In women, it can lead to inflammation of the fallopian tubes, cervix, pathologies of pregnancy and childbirth, diseases of the liver, spleen; in men – to inflammation of the epididymis, prostate gland, bladder, and impaired potency. Newborns may develop conjunctivitis, nasopharyngeal lesions, and pneumonia.

Trichomoniasis

Symptoms. They can appear 4–21 days after infection, sometimes later. Women experience copious foamy discharge of a white or yellowish-green color with a pungent odor, causing severe itching and irritation of the genitals, as well as pain, burning during urination, and pain during sexual intercourse. Men experience a burning sensation when urinating, mucopurulent discharge from the urethra. However, this disease is often asymptomatic.

Why is it dangerous? In women, the cervix and inner layer of the uterus, fallopian tubes, ovaries, and urinary tract are affected. The infection can even cause peritonitis! In men, the prostate gland, testicles and their appendages, and urinary tract are affected.

Mycoplasmosis (in men - ureaplasmosis)

Symptoms. It may reveal itself 3 days after infection, or maybe a month later, manifested by itching and discomfort in the genital area, scanty transparent discharge, and painful urination.

Why is it dangerous? A common complication of trichomoniasis in women is inflammation of the genital organs; in men, a disorder of spermatogenesis.

Gonorrhea

Symptoms. 3–7 days after infection, women experience yellowish-greenish vaginal discharge, frequent, painful urination, pain in the lower abdomen, and sometimes bloody discharge. However, in most representatives of the fairer sex the disease goes unnoticed for a long time. Men experience pain and burning when urinating, yellowish-greenish purulent discharge from the urethra.

Why is it dangerous? In women, the urethra, vagina, anus, uterus, ovaries, and fallopian tubes are affected. In men, the internal genital organs develop chronic inflammation of the epididymis, seminal vesicles, and prostate, which threatens impotence and infertility.

Syphilis

Symptoms. The incubation period of the disease is from 3 to 6 weeks. The first sign is a round ulcer (chancre). In women, it lives on the labia or vaginal mucosa (sometimes in the anus, in the mouth, on the lips), in men - on the penis or scrotum. In itself, it is painless, but a week or two after its appearance, the nearest lymph nodes enlarge. This is the time to start treatment! This is the first stage of the disease, when everything is still reversible. 2–4 months after infection, the second stage develops - a rash “spreads” throughout the body, high fever and headache appear, and almost all lymph nodes become enlarged. In some patients, hair falls out on the head, and wide condylomas grow on the genitals and in the anus.

Why is it dangerous? This disease is called slow death: if it is not fully treated in time, serious problems arise with the musculoskeletal system, irreversible changes occur in the internal organs and nervous system - the third stage of the disease begins, in which approximately a quarter of patients die.

Forget about the Internet!

Noticed something is wrong? It’s better to play it safe and hurry to see a doctor, rather than look for symptoms and treatment methods on the Internet.

How are STDs diagnosed? First, an examination by a doctor, then tests and studies. The most modern method of DNA diagnostics: PCR (polymerase chain reaction). For examination, scrapings are taken from the urethra, vagina and cervix.

Doctors also use the ELISA method (blood is taken from a vein or a scraping is made and the presence of antibodies to STDs is determined), bacterioscopy (most often detects gonococci and trichomonas) and many other diagnostic methods.

STDs are treated with antibacterial drugs, as well as local procedures (washing the urethra in men, sanitizing the vagina in women and other procedures). At the end of the course of treatment, you must undergo a follow-up examination - take several tests to make sure there is no infection in the body.

How to protect yourself?

The classic self-defense against STDs is the condom. High quality and correctly sized.

Emergency drug prevention is also used - a one-time dose or injection of antibacterial drugs, which can only be prescribed by a dermatovenerologist. The procedure helps prevent gonorrhea, chlamydia, ureaplasmosis, mycoplasmosis, syphilis and trichomoniasis. But this method cannot be used often.

But as for douching after sexual intercourse with special gels or chlorine-containing antiseptics, most experts believe that this does not reduce the risk of infection.

Since many diseases do not have characteristic symptoms, and for those that do have them, special medical education is necessary for recognition, I will give all the conditions that may indicate the presence of a sexually transmitted infection in a person. These are:

• The appearance of itching, discomfort, burning, pain, pain in the urethra or vagina
• Frequent and/or painful urination
• Presence of any discharge from the genitourinary organs
• The appearance of any rash on the genitals
• Any rash on the torso, palms, soles, or oral mucosa
• Enlarged lymph nodes
• Hair loss

The following group of symptoms is observed with complications of sexually transmitted infections

• Heaviness, tingling, pain in the lower abdomen, perineum, testicles
• Menstrual irregularities
• Difficulty urinating
• Premature or prolonged ejaculation
• Changes in sperm quantity and color
• Barren marriage

All sexually transmitted infections in some cases can be asymptomatic. Therefore, in the absence of signs of the disease, it is always necessary to undergo examination in the following cases:

• If you have had casual sex without using a condom, even in the absence of the above symptoms, regardless of the type of sexual contact
• If a sexually transmitted infection has been detected in a regular sexual partner

In some cases (for example, when planning a pregnancy), so-called screening for sexually transmitted infections is indicated in order to identify and treat them (for example, before pregnancy)

Where to contact

Currently in Russia you can get medical care:

• In municipal clinics (dermatology and venereal disease clinics) at the place of residence
• In various specialized medical commercial medical centers
• From private practitioners

Our advice is to carefully ask your acquaintances and friends whether such problems have happened to them and where they were treated, try not to advertise your illness, refer to “that a friend is sick, where should he/she go?” etc. Remember that the news that you are sick can negatively affect your reputation in the team. Once you find out where they were treated and reviews about the doctor, go there.
If this option does not suit you, contact a clinic or specialized medical centers.

Municipal clinic (dermatovenerological dispensary)

When applying, you will need a passport and an insurance policy. If you suspect that the cause of your illness is a sexually transmitted infection, contact a dermatovenerologist. Of course, women can see a gynecologist, and men can see a urologist (andrologist), but a venereologist can quickly recognize the skin manifestations of syphilis, which can occur together with genitourinary infections. In a municipal clinic (dispensary) you can receive medical care completely free of charge (with the exception of additional paid tests), in cases of syphilis or gonorrhea you will have to sign a “Warning to the patient about a sexually transmitted disease”, from the moment of signing which you will bear legal responsibility liability for intentional infection with a venereal disease, after completion of treatment you will be registered and you will be required to regularly attend control examinations without fail.

Specialized Medical Center

A simpler and more reliable option is to visit a specialized medical center, which are now available in almost any city. Narrow specialization and experience in diagnosing and treating sexually transmitted infections allow the doctors working there to quickly make a diagnosis and prescribe quality treatment. The only drawback is that you have to pay for everything. When visiting the center, ask whether there is a license, what services the institution can provide in accordance with it, there must be an approved price list.
When paying, keep the payment document (receipt, check) issued to you; you may need it later. If you agree to be treated at the center, immediately discuss with your doctor what guarantees he can provide. Of course, medicine is not a watchmaking workshop, but the concept of a guarantee should include free repeat course of treatment if the first is unsuccessful.

Private practitioner

How to behave at a doctor's appointment

First of all, the doctor is interested in complaints and the timing of the disease. Complaints must be stated clearly; if discharge is bothersome, it is necessary to immediately clarify its quantity, color, time of appearance; if pain occurs, its location, severity, connection with urination, sexual intercourse. It is important to accurately determine the onset of the disease. , expressions like “It started for me when I was at sea” do not convey any information, but only lengthen the appointment time. There is no need to be shy about the doctor - if you have had unconventional sexual contacts - oral or anal - be sure to inform - this will give additional information and will help make the correct diagnosis.

Inspection

If syphilis is suspected, it is necessary to examine all the skin, scalp, mucous membranes of the mouth, anal area, and not just the genital organs. If a genitourinary infection is suspected in men, the head of the penis, the external opening of the urethra, the scrotum are examined, if indicated - rectally ( through the anus) prostate gland. In women - the vestibule of the vagina,
external opening of the urethra, cervix using a vaginal speculum.

What tests need to be taken

The diagnosis of any sexually transmitted infection must be confirmed laboratory. An exception is made only for two diseases: the diagnosis of genital herpes and scabies can be established on the basis of clinical signs (Order of the Ministry of Health of the Russian Federation No. 403 of 2003). Basically, the necessary studies are prescribed based on the data obtained during a survey of the patient and an external examination. Research can be divided into laboratory (for their implementation it is necessary to collect biological material from the patient) and instrumental (the use of special instruments to examine various organs of the patient directly). Sometimes a so-called screening examination is carried out - in the absence of visible clinical signs to exclude hidden pathology and carriage of pathogenic microorganisms.

Laboratory research

If syphilis is suspected, a serological test of blood from a vein is prescribed (CSR, ELISA, RPGA, RIT, RIF), in the presence of ulcers or erosions on the mucous membranes - a dark-field study

If genitourinary infections are suspected, a bacterioscopic smear from the urethra in men; urethra, vagina and cervical canal in women is required (in addition to identifying the pathogen, the smear is used to determine the presence or absence of an inflammatory process in the genital organs). Many pathogens cannot be determined using this examination , therefore, in addition, he must be examined using the cultural method (bacteriological culture) or polymerase chain reaction (DNA diagnostics). This is due to the fact that a combination of several infections (mixed infections) often occurs. For example, gonorrhea and chlamydia - gonorrhea is easily determined by a smear, and to diagnose chlamydia, a study using PCR is required. For the purpose of topical diagnosis (which organs of the reproductive system are affected), a general urine test, glass urine samples, examination of prostate secretions, spermograms are prescribed. Sometimes an immunological blood test is prescribed - enzyme immunoassay analysis for the presence of antibodies of various classes against pathogens of sexually transmitted infections. This study sometimes helps to determine the infection if the pathogen is in the fallopian tubes in women, the prostate gland and epididymis in men, but is not decisive in establishing an etiological diagnosis.

Instrumental studies

They are prescribed for topical diagnosis of the disease and to identify complications. Mainly prescribed are urethroscopy (examination of the urethra), colposcopy (examination of the vagina and cervix) and ultrasound examination of the prostate gland, organs of the scrotum, uterus and uterine appendages.

What are the special requirements for testing?

When taking smears from the genital organs and PCR, men do not urinate for 3 hours or more, women do not do the morning toilet and douching.
During a serological examination for syphilis using the CSR method (Wassermann reaction), blood from a vein is donated on an empty stomach
When testing for syphilis and other sexually transmitted infections using ELISA, there are no special requirements
When submitting prostate secretions and spermogram, abstain from ejaculation for 3-5 days.

How are sexually transmitted diseases diagnosed?

The data from the survey, examination and laboratory tests are summarized by the doctor and he makes a diagnosis of a sexually transmitted infection. The diagnosis must comply with the International Classification of Diseases, X revision. In addition to indicating the pathogen that caused the disease, the diagnosis must indicate which organ of the reproductive system is affected (urethra, vagina, bladder and .etc.).Many diagnoses that are made by doctors are currently not legally competent, but are more understandable to patients. For example, the diagnoses of gardnerellosis, ureaplasmosis, mycoplasmosis are acceptable in popular scientific literature, but their use in official documents (medical record, history illness, discharge, certificate) is unacceptable.

What is the prescribed treatment for sexually transmitted diseases?

Depending on the established diagnosis, treatment is prescribed.
For a number of infections (syphilis, gonorrhea, chlamydia, trichomoniasis, candidiasis, herpes,
anogenital warts, bacterial vaginosis) The Ministry of Health has developed standard methods. If for genitourinary infections changes in treatment methods are allowed by the attending physician, then treatment of syphilis must be carried out exactly according to the instructions in order to evaluate the results of treatment during dynamic observation.
Treatment of sexually transmitted infections is carried out by prescribing certain antibiotics depending on the diagnosis. Treatment without antibiotic therapy is unacceptable. The use of various homeopathic drugs, physiotherapeutic devices, immunostimulating agents without antibiotic therapy leads to chronicity of the process and the appearance of complications.

Usually the doctor prescribes a list of medications needed for treatment, which the patient buys at the pharmacy himself. In some medical centers, the cost of the course of treatment includes the cost of medications purchased by the medical center itself. Although from a legal point of view this is somewhat illegal, from a practical point of view the patient is exempt from searches for the necessary drugs in pharmacies and, most importantly, the center’s doctors take responsibility for the outcome of treatment - i.e. interested in a quick and complete cure of the patient with the drugs they purchased.

What to do with sexual partners

Sexual partners of patients with sexually transmitted infections are subject to mandatory examination. If the causative agent of the disease is not found in them, they must either receive preventive treatment or undergo periodic clinical and laboratory examinations over a certain period of time (depending on the diagnosis)

What not to do during treatment for sexually transmitted diseases

During the course of treatment, unprotected sexual intercourse (including orogenital and anogenital). Taking some antibiotics is incompatible with a number of medications. No connection has been established between alcohol consumption and the resulting low effectiveness of antibiotic therapy (see)

How to find out if there has been a cure for sexually transmitted diseases

After the course of treatment, it is necessary to determine whether a cure has occurred. Monitoring of the cure is carried out after a certain period of time after the end of treatment (depending on the diagnosis). There are:

Etiological cure

When the pathogen is not determined during laboratory examination within a certain period after treatment for each disease

Clinical cure

When there are no clinical signs (symptoms) of the disease

Complete cure

They are quite widely known to everyone due to the method of their distribution. They plague humanity for many centuries, perhaps even millennia, leading to serious illness, infertility, deformities of newborns and untimely deaths. Doctors have learned to cope well with some infections, but some of them can still either be cured in the early stages of the disease, or are still able to resist our efforts.

Before formulating a complete list of STIs, you need to find out what they are, how they threaten people and how they affect the body.

Sexually transmitted infections, or STIs, are transmitted from one sexual partner to another, uninfected one, through unprotected sexual intercourse in any form. Pathogens can be viruses, bacteria, fungi, etc.Quite often a mixed form of infection is observed, especially in people who are promiscuous without protection, prone to antisocial behavior, drug addiction, and alcoholism.

Not understanding the risk of contracting some types of STIs can be costly. They can lead to chronic inflammatory processes in the human genital area, cause miscarriage or impotence and prostatitis in men, damage to the immune system, which can cause severe diseases, even fatal.

Some infections only affect the reproductive system, but they can also “spread” throughout the body and cause irreparable harm to health, affecting even the spinal cord and humans.

The only reliable protection against STIs may be caution and attentiveness when choosing a sexual partner, high-quality protection and timely, comprehensive treatment if an infection is detected. Both partners need to be treated.

List of STIs: types, description and signs

Sexual infections include diseases that enter the human body from the outside, from an infected partner, and those whose pathogens normally constantly live on our skin and mucous membranes without causing any harm. These microorganisms are called opportunistic flora.

As long as the body is healthy, and the immune system resists the onslaught of infection and maintains the number of microorganisms at a low, harmless level, the disease does not occur. But during sexual contact with a carrier of the same type or when immunity decreases, the number of pathogens increases sharply and the person becomes ill. Such diseases include the well-known thrush, or candidiasis. Its pathogens are constantly present in the body of every person, but the disease occurs only when a number of conditions coincide.

A number of pathogens of sexually transmitted diseases respond quite well to treatment with modern drugs, but it is better to do this as early as possible, before the infection causes serious inflammatory processes.

As a result, adhesions may occur that threaten a woman with infertility, lesions, unpleasant external rashes and even cancerous tumors. There are some STIs that, when left untreated, can be fatal. This is , and . With timely and correct treatment, the life of such patients can be extended for quite a significant time.

Useful video - Signs of STDs.

The concept of STIs, or (sexually transmitted diseases) is somewhat broader than the concept of sexually transmitted diseases. “Diseases of Venus” are included in the list of sexually transmitted infections as part of it.

Full list of STIs:

• Syphilis is caused by treponema pallidum, or spirochete, has three stages and can be congenital. Capable of affecting the skin, mucous membranes, soft and bone tissues, and the central nervous system. It is easily transmitted not only through sexual intercourse, but also through blood and household contact with the personal belongings of an infected patient - a carrier of treponema. It manifests itself as a rash, ulcers, and specific formations - chancre and gumma. Secondary and tertiary syphilis can occur in a latent form. If left untreated, it leads to numerous health and mental problems, and then death.
• Gonorrhea is caused by gonococci and affects the mucous membranes of the urethra and, and when the disease spreads, the bladder, conjunctival membranes, pharynx, and oral mucosa. It manifests itself as purulent discharge, burning sensation and pain with frequent visits to the bathroom. Can be acute or chronic.
• Trichomoniasis is very common in all countries of the world and can be transmitted through household means. In men, it manifests itself as painful urination and bloody discharge. Women experience severe redness of the vulva, burning, itching, copious discharge, and pain during sexual intercourse.
• is caused by chlamydia and has a very secretive “character”. Due to the absence of external manifestations, the level of infection spread is very high. In advanced forms, women may experience itching, pain and burning, as well as unpleasant-smelling discharge. Men mainly experience burning and itching when urinating.
• Mycoplasmosis is provoked by opportunistic microorganisms, mycoplasmas, and more often affects women, causing vaginosis and inflammatory diseases of the internal genital organs.
• can be transmitted not only sexually, but also during childbirth from mother to newborn. It almost always passes without pronounced symptoms, but with a large number of ureaplasmas in men, signs of prostatitis may appear and classic symptoms of infection may occur - itching, burning and pain.
• Gardnerellosis is a type of bacterial vaginosis associated with the “displacement” of lactobacilli and their replacement with gardnerella and some other microorganisms. It has several ways of appearance, not only sexually. A very common condition.
• Candidiasis, or thrush, is also extremely common and can occur without external influence, such as the use of antibiotics. It manifests itself as abundant cheesy discharge, severe itching, irritation and inflammation. It can affect not only the genitals, but also the oral cavity.
• The human papillomavirus () is transmitted sexually and domestically, has many varieties, some of which can cause cancer and, others provoke the formation of genital warts on the genital and anal mucous membranes. It manifests itself as the appearance of wart-like formations on the skin and mucous membranes, which can be single or turn into continuous affected areas.
• Cytomegalovirus spreads through sexual and household contacts and through various bodily fluids. It is asymptomatic, especially dangerous for pregnant women, as it affects.
• It spreads not only through sexual contact, but also through any contact with infected blood. It develops slowly and attacks the immune system, causing AIDS. Patients most often die from secondary infections, for example, from pneumonia, since the patient’s immune system, killed by the virus, does not resist.
• also have many ways of spread, including sexually. With these dangerous diseases, a change in structure and functioning occurs, which is manifested by a series of characteristic symptoms.
• Lymphogranuloma venereum affects the skin and lymph nodes of an infected person. It is rare in Europe and the Russian Federation, since the main region of its distribution is Africa and South America. Asia and India. Caused by a special type of chlamydia, it manifests itself as blisters, ulcers, inflammation of the lymph nodes, fever, headache and indigestion.

As can be seen from the list, some infections are of a viral nature (CMV, herpes, papillomatosis and condylomatosis, hepatitis, HIV and others), fungal (candidiasis), bacterial (gonorrhea), or provoked by protozoan microorganisms (ureaplasmosis, mycoplasmosis and others). Accordingly, treatment should be tailored to the specific pathogen. For mixed infections, combined treatment is used.

List of STI infections in women, how tests are taken, first signs

• Smearfor microflora. A sample of discharge from 3 points of the genital canal is taken from a woman with a special probe. Next, the material is placed on glass, stained with a special acidic medium for a detailed study of the composition of the secretion, and carefully examined under a microscope. This method identifies pathogens of fungal and bacterial origin. Viruses cannot be detected using a genital swab.
• Culture of secretions. The culture procedure is carried out in a bacteriological laboratory and takes a long time (about a week). The result of this examination unmistakably indicates the presence of any disease.
• PCR (polymerase chain reaction). One of the most informative tests that allows you to accurately confirm a preliminary diagnosis. To perform it or pass a DNA pathogen test, a sample of discharge from the genital canals or urine is taken. The duration of a study using this method does not exceed two days, the accuracy of the analysis is up to 95%.
• ELISA – transcript (enzyme immunoassay). If a woman has purulent inflammation, specialists prescribe ELISA. A sample of discharge taken from the vagina is examined. The study is carried out quite quickly, its result is ready 5-6 hours after taking the sample.
• Blood test. To determine specific antibodies, a venous blood test is prescribed. The purpose of such a study is to determine whether an immune response will occur to the presence of a particular pathogen. This method is effective when it is necessary to confirm the diagnosis of viral origin (genital herpes, HIV) and syphilis. The method is not used to diagnose bacterial infections, including chlamydia.

In addition to the tests listed, the venereologist prescribes a clinical and biochemical blood test, which can reveal an increase in ESR and leukocytosis. Not all sexually transmitted infections in women can be treated; for example, human papillomavirus infection and genital herpes can only be stopped.

The need for long-term treatment of these diseases and a wide range of complications should motivate you to consult a doctor in a timely manner.

Treatment

A number of pathogens of sexually transmitted diseases respond quite well to treatment with modern medications, but it is recommended to start treatment as early as possible, before serious inflammatory processes begin.

Appropriate therapy for STIs is prescribed according to a special scheme only by the attending physician based on the results of the examination. Depending on the pathogen, complex treatment is used, since the complex course of such diseases requires the use of not only drug therapy.

Most sexually transmitted diseases can be successfully treated, but today there are some that are incurable:

• herpes type 1 and 2;
• hepatitis C;

Important! To avoid relapse, after completing the course of treatment for an STI, a woman must take all tests again. This will ensure that the disease is cured.

Complications and consequences

Delayed treatment of sexually transmitted diseases in women or its complete absence, as well as self-medication, causes the following serious complications:

• transition of the disease to the chronic stage;
• spread of infection throughout the body;
• infertility;
• development of cancer of the cervix, rectum, etc.

Prevention

Any disease is much easier to prevent than to cure, and diseases included in the list of STIs are no exception. You can protect yourself from these diseases by the following methods:

• using a condom protects against many infections;
• by avoiding contact with people at risk (alcoholics, drug addicts, etc.), you can avoid many risks;
• You can engage in non-traditional forms of sex (anal, oral) only with a partner with whom you have a trusting relationship and whose health there is no reason to doubt.

The additional use of special medications can help in some cases to cope with certain types of infection. However, these drugs have contraindications and side effects. They should be used irregularly, for example, at the first contact with a partner as additional protection along with a condom.

Sexually transmitted diseases are transmitted in most cases through sexual contact. It is important to remember: unprotected sex, promiscuity and a sick partner are a high risk of contracting such ailments. Diagnosis of such diseases is somewhat difficult due to the late onset of the disease and the paucity of symptoms. Their treatment is problematic, since the resistance of microorganisms to antibiotics is increasing every year.

STIs have severe complications, so the appearance of specific symptoms: rashes, discomfort, irritation, uncharacteristic discharge from the genitals is a signal to consult a doctor.